Latar BelakangSetiap tahun, 13,8 juta kasus neurologis di dunia membutuhkan operasi; di Indonesia, kebutuhan operasi elektif bedah saraf meningkat seiring waktu, diperparah populasi lansia yang bertumbuh, beban penyakit tidak menular, dan dampak pandemi COVID-19. Walaupun optimalisasi penjadwalan operasi elektif sudah diupayakan, disparitas waktu tunggu tetap terlihat. Guna menghindari penjadwalan yang kurang proporsional atau etis, penelitian ini menginvestigasi waktu tunggu operasi elektif bedah saraf dan hubungannya dengan berbagai karakteristik sosiodemografis pasien.MetodePenelitian potong lintang ini menganalisis rekam medis pasien operasi bedah saraf elektif di RSCM antara bulan Juli 2021—Desember 2023 secara retrospektif. Selain penyajian data durasi waktu tunggu (keputusan hingga tanggal dilakukannya operasi) secara deskriptif, perbedaan rerata waktu tunggu antarkelompok jenis kelamin, usia, agama, status pernikahan, jarak tempat tinggal, pekerjaan, divisi operasi, dan asuransi kesehatan dianalisis dengan uji yang sesuai. Regresi linear dilakukan dengan karakteristik pasien sebagai prediktor durasi waktu tunggu.HasilDari 765 data rekam medis yang dianalisis, diperoleh median waktu tunggu selama 16 (1—1109) hari. Pasien perempuan, berusia 40—55, janda/duda, atau berasuransi BPJS menunggu lebih lama dibandingkan kelompok lainnya. Sebaliknya, tidak terdapat perbedaan signifikan antarkategori tempat tinggal dan pekerjaan. Regresi linear menunjukkan asuransi BPJS, jenis kelamin perempuan, dan operasi divisi trauma menjadi prediktor-prediktor signifikan bagi durasi waktu tunggu operasi elektif bedah saraf yang lebih lama di RSCM.KesimpulanJenis kelamin, usia, status pernikahan, asuransi kesehatan, dan divisi operasi berhubungan dengan waktu tunggu operasi elektif bedah saraf. Determinan sosial perlu dipertimbangkan dalam pengambilan keputusan penjadwalan.

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Introduction

Each year, 13.8 million neurological cases worldwide require surgery; in Indonesia, the need for elective neurosurgery has been increasing over time, compounded by the growing elderly population, the burden of non-communicable diseases, and the COVID- 19 pandemic. Despite optimization efforts made to schedule elective surgeries, inequities in waiting times are still evident. To avoid disproportionate and unethical scheduling, this study investigates the waiting times for elective neurosurgery and their association with various sociodemographic characteristics of patients.

Method

This cross-sectional study retrospectively analyzed randomly-sampled medical records of elective neurosurgery patients at Cipto Mangunkusumo Hospital (RSCM) from July 2021 to December 2023. In addition to presenting the waiting time duration (from decision to surgery date) descriptively, mean differences in waiting times between groups based on gender, age, religion, marital status, residence distance, occupation, surgery division, and health insurance type were appropriately analyzed. Linear regression was performed with patient characteristics as predictors of waiting times.

Results

The median waiting time of 765 analyzed patients was 16 (1–1109) days. Patients who were female, aged 40–55, widowed, or publicly insured waited longer compared to their counterparts. Conversely, no significant differences were found between categories of residence distance and occupation. Linear regression showed that public insurance, female gender, and trauma division surgeries were significant predictors of longer waiting times for elective neurosurgery at RSCM.

Conclusion

Gender, age group, marital status, health insurance, and surgery division are related to the waiting times for elective neurosurgery. Social determinants should be considered in scheduling decision-making.